Background: Gender differences in metabolic response to lifestyle interventions remain poorly explored. This study aimed to evaluate the impact of a six-month Mediterranean diet (MD) intervention combined with regular physical activity on metabolic parameters in overweight adults. Methods: A prospective cohort study was conducted in an obesity clinic in Rome, Italy, involving overweight adults (BMI ≥ 25 kg/m2) motivated to improve their lifestyle. Participants (n = 205; 107 men and 98 women) self-selected into physical activity groups (aerobic, anaerobic, combined or no activity). Gender-specific metabolic changes were assessed, including lipid profiles, liver markers and fasting glucose. Results: Significant gender differences in metabolic results were observed. Men showed greater reductions in total cholesterol (TC) and LDL, as well as significant reductions in alanine aminotransferase (ALT). Women showed a significant increase in HDL cholesterol. Fasting blood glucose decreased significantly in both sexes, with no differences between the sexes. Activity-specific analysis revealed that anaerobic activity significantly improved lipid metabolism in men, while aerobic activity produced the greatest benefits in women, including increased HDL and improved liver marker profiles. Conclusions: Therapeutic strategies combining MD and physical activity must take into account gender-specific physiological differences and the type of sport activity to optimise metabolic benefits. Personalised approaches may improve the management of cardiovascular risk factors in overweight individuals. Study registration: This study is registered on ClinicalTrials.gov (NCT06661330).

Dermatological diseases such as acne, hidradenitis suppurativa (HS), and psoriasis are driven by chronic inflammation and oxidative stress. Emerging evidence highlights the role of nutrition in modulating these conditions, particularly through dietary patterns rich in antioxidants, polyphenols, and unsaturated fatty acids. The Mediterranean diet (MedDiet) has demonstrated potential benefits due to its anti-inflammatory and immunomodulatory effects, while very low-energy ketogenic therapy (VLEKT) has shown promise in rapidly improving disease severity. Specific nutrients, including omega-3 fatty acids, probiotics, and micronutrients, may further contribute to disease management. However, the current literature is limited by small-scale studies and the lack of standardized dietary guidelines. This Consensus Statement, developed collaboratively by the Italian Association of Dietetics and Clinical Nutrition (ADI), the Italian Society of Dermatology and Sexually Transmitted Diseases (SIDeMaST), the Italian Society of Nutraceuticals (SINut), Club Ketodiets and Nutraceuticals “KetoNut-SINut” and the Italian Society of Endocrinology (SIE), Club Nutrition, Hormones and Metabolism, aimed to establish an evidence-based framework for medical nutrition therapy (MNT) of the most common inflammatory skin diseases, including acne, HS and psoriasis.

Gender differences in dietary habits, physical activity and body composition are key determinants of health and disease risk. Although these differences are well documented, their variation across age groups remains poorly explored. This study examines gender-specific patterns in eating behaviours, sport preferences and body composition metrics, with the aim of providing evidence for tailored public health interventions. A cross-sectional study was conducted on 2,276 participants (1,349 females and 927 males) aged 18–75 years. Recruitment combined an online survey and clinical assessments. Body composition was evaluated with bioelectrical impedance analysis (BIA) and eating habits were investigated with detailed weekly food diaries. Gender differences between five age groups were statistically analysed using chi-square and t-tests (p ≤ 0.05). The study protocol was approved by the Lazio Area 5 Ethics Committee. Significant differences in body composition were observed between genders: men had a higher lean mass and basal metabolic rate, whereas women showed a higher fat mass in all age groups. Eating habits varied significantly: men preferred salty and protein-rich foods, consumed alcohol more frequently and showed a higher prevalence of meal skipping and uncontrolled eating behaviour. Women showed greater meal regularity, a preference for sweet tastes and a higher likelihood of eating alone in the older age groups. Sports participation differs markedly in the age group 30–39 years, in which men were predominantly involved in team sports, while women favoured strength training and skill activities. This study highlights the strong gender disparities in dietary and lifestyle behaviour, which evolve with age. These findings underline that tailored public health strategies, responding to gender-specific requirements, are needed to promote healthier lifestyles and reduce inequalities. Future studies should use longitudinal designs to explore causal relationships. The study is registered on ClinicalTrials.gov (NCT06661330; registered 22 October 2024, retrospectively). Available at: https://clinicaltrials.gov/study/NCT06661330 .

This study analyzes the long-term outcomes of metabolic bariatric surgery (MBS), focusing on weight loss, nutritional deficiencies, and patient satisfaction. We evaluate different surgical techniques to identify their impact on these outcomes. A five-year retrospective analysis was conducted on 249 patients who underwent MBS at a specialized center. Baseline characteristics included an average age of 38.5 years, weight of 118.5 kg, and BMI of 43.2 kg/m². Weight loss outcomes were assessed using mean excess weight loss (

Introduction:Weekend eating habits are often different from those of weekdays, but their impact on body composition remains little explored. This study investigates gender and age differences in weekend eating behaviors and their association with fat mass percentage (FM%). Methods:A cross-sectional study was conducted on 2,596 participants at an obesity center in Italy. Eating habits were assessed with a self-reported questionnaire, classifying weekend eating behavior into four categories: maintaining weekday eating patterns, cooking at home, eating out, and eating prepared meals. Weekday eating was considered the participant's habitual eating pattern as reported during clinical evaluation. Differences in FM% between groups were analyzed by ANOVA and the influence of gender and age was examined by multiple linear regression models. Results:Significant differences between gender and age were observed specifically in weekend eating behaviors (p < 0.001). Women were significantly more likely to cook at home, whereas men, particularly those aged 18-30 years, were more likely to eat out. Women who cooked at home during the weekend had a higher FM% than those who ate out or maintained weekday eating habits (p < 0.001) but consistency alone does not guarantee better body composition, as the quality of the diet was not assessed. Among men aged 31-45 years, cooking at home was associated with a higher FM% than maintaining weekday habits (p = 0.0028). Regression analysis showed that FM% was higher in females and older age groups, while eating out, being hosted, or maintaining weekday habits were associated with lower FM% compared to cooking at home (all p < 0.05). Conclusion:Weekend eating habits represent a distinct and influential factor on body composition, rather than a simple extension of weekday patterns. The results emphasize that gender- and age-specific approaches are crucial in dietary interventions, particularly for younger men and women who maintain structured meal patterns. These results suggest that weekends may be an important period for dietary interventions based on self-reported dietary patterns, with potential implications for gender- and age-specific dietary interventions and broader public health strategies aimed at improving long-term metabolic outcomes.

Intermittent fasting (IF) has gained attention as a potential intervention for cardiometabolic health, though its long-term effects remain unclear. In this randomized clinical trial, we assessed the impact of 6 months of IF on body composition, cardiovascular risk factors, and related molecular pathways in middle-aged (30-65 years) men and women with overweight (BMI 24.8-35 kg/m²). In this trial, 41 participants were randomized to either an intermittent fasting (IF) intervention or to maintain their habitual diet. The primary outcome (circulating CRP concentration) was previously reported; here, we present exploratory analyses focusing on metabolomic and transcriptomic responses. IF led to an 8% reduction in body weight, a 16% decrease in body fat, and significant improvements in lipid profile, including substantial reductions in plasma LDL-cholesterol, non-HDL-cholesterol, and triglycerides (p = 0.001). However, no significant changes were observed in other cardiometabolic risk factors. To investigate the underlying molecular mechanisms, we performed untargeted plasma metabolomics and transcriptomic analysis of colon mucosa biopsies. Significant multi-omic changes were identified, particularly in lipid metabolism, bile acid signaling, and enteroendocrine regulation. Notably, there was a downregulation of transcripts related to glucagon-like peptide 1 (GLP-1) and related enteroendocrine hormones. Correlation analysis highlighted key molecular pathways, with PPAR-α and B-cell-mediated immune processes significantly associated with changes in non-HDL cholesterol. Our findings extend the understanding of IF in humans beyond weight loss, providing key mechanistic insights to inform targeted therapies for improving cardiometabolic health. ClinicalTrials.gov NCT01964118.

Metabolic and bariatric surgery (MBS) is the most effective treatment for severe obesity and its metabolic complications. Currently, most MBSs are performed laparoscopically. However, high weight associated with an enlarged liver (especially the left lobe liver section, LLLS) may complicate the technical aspects of this surgery. Therefore, before MBS, moderate preoperative weight loss (PreopWL), and reduction in LLLS are desirable. Moreover, studies are inconclusive regarding which is the best approach to apply. This narrative review aimed to describe the current scientific evidence on the effect of a noninvasive approach, such as dietary or pharmacotherapy or space-occupying devices on PreopWL, peri-operative complications, hospital length of stay, and post-operative complications in patients with obesity scheduled for MBS. We conducted a literature search and screening for relevant publications from January 2010 to June 2024. We found that PreopWL before MBS is helpful for both patients and surgeons, as it leads to various benefits, such as a decrease in body weight and LLLS size, a lower risk of intra- and post-operative complications, shorter surgery times, and reduced hospital stays. In this context, concerning dietary approaches, several dietary protocols have been introduced over time, among which very low-calorie diets and very low energy ketogenic therapy are widely prescribed; however, larger randomized-controlled trials (RCTs) with well-defined dietary protocols are necessary to make definitive conclusions. Obesity management medications, such as the lipase inhibitor orlistat, phentermine/topiramate, naltrexone/bupropion, the glucagon-like peptide-1 receptor agonists (GLP-1RAs) liraglutide and semaglutide, and the novel dual glucose dependent insulinotropic peptide (GIP)/GLP-1 receptor agonist tirzepatide, has shown to be effective in promoting PreopWL before MBS; however, larger, well-designed RCTs are needed to establish optimal treatment protocols and assess their true benefits in patients scheduled for MBS. Space-occupying devices such as the swallowable intragastric balloon and hydrogel capsules, represent a promising tools but further research is essential to confirm their role.

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Malnutrition, a significant risk factor for mortality and morbidity in the elderly, poses a huge threat in the geriatric population, showing a high prevalence, especially in people affected by chronic non-communicable age-related diseases [...]

Abstract Background Insulin-like growth factor (IGF)-1 and its binding proteins are important in cancer growth, especially in prostate cancer. Observational studies suggest that protein restriction can lower IGF-1 levels. However, it is unclear whether an isocaloric protein-restricted diet affects IGF-1 and IGFBPs in men with prostate cancer. Methods In this academic, single-center, parallel-group, prospective, randomized, open-label, blinded end-point trial, 38 consenting overweight (BMI 30.5 ± 5.5 kg/m2) men with localized prostate cancer, aged 43–72 years, were randomized (1:1) with permuted blocks to 4–6 weeks of customized isocaloric PR diets (0.8 g protein/kg lean body mass) or their usual diet. Biomarkers influencing cancer biology, including serum IGF-1 and its binding proteins were measured longitudinally. Results Contrary to our hypothesis, feeding individuals an isocaloric protein-restricted diet did not result in a significant reduction in serum IGF-1. Moreover, there was no observed increase in serum IGFBP-1 or IGFBP-3 concentration. Conclusion These findings demonstrate that protein restriction without calorie restriction does not reduce serum IGF-1 concentration or increase IGFBP-1 and IGFBP-3 in men with localized prostate cancer. Further research is needed to identify dietary interventions for safely and effectively reducing IGF-1 in this patient group.

The increase in elderly populations worldwide highlights the urgency of addressing age-related problems through effective nutritional management to enhance the well-being of the elderly and for the prevention and treatment of various diseases. The trend towards an increasing elderly population brings with it an increase in conditions such as sarcopenia, osteosarcopenia and frailty, emphasising the importance of regular checks for malnutrition in the elderly and the implementation of personalised nutritional therapies. The importance of nutrition in addressing geriatric syndromes such as frailty, sarcopenia, osteosarcopenia, obesity and metabolic syndrome is highlighted. Dysphagia, frequent in the elderly, requires special attention to prevent malnutrition and complications. It is essential to maintain muscle mass and bone health in old age. In this review we investigate the fundamental role of nutrition in geriatrics, focusing on promoting healthy ageing and managing problems such as malnutrition and overeating. The importance of protein intake and healthy dietary patterns such as the Mediterranean diet are then discussed. Finally, the challenges of personalised nutritional care, including the need for artificial nutrition or oral supplements, to improve quality of life and health care in an ageing society are addressed.

This narrative review critically examines the current research on the health implications of whey protein (WP) supplementation, with a focus on potential risks and adverse effects. WP, commonly consumed for muscle building and weight loss, has been associated with various health concerns. Our comprehensive analysis involved a thorough search of multiple databases, resulting in the inclusion of 21 preclinical and human studies that collectively offer a detailed overview of WP’s health impacts. The review reveals significant findings, such as WP’s potential link to liver and kidney damage, alterations in gut microbiota, increased acne incidence, impacts on bone mass, and emotional and behavioural changes. These findings underscore the complexity of WP’s effects on human health, indicating both beneficial and detrimental outcomes in relation to different posologies in a variety of settings. Our study suggests caution for the protein intake in situations of hepatic and renal compromised functions, as well as in acne susceptibility, while possible beneficial effects can be achieved for the intestinal microbiota, humoral and behavioural level, and finally bone and muscle mass in elderly. We emphasizes the importance of balanced WP consumption and call for more in-depth research to understand its long-term health effects. Health professionals and individuals considering WP supplementation should be aware of these potential risks and approach its use with informed caution.

BackgroundGender differences in dietary patterns and physical activity are known to influence metabolic health, but research exploring these differences using principal component analysis (PCA) is limited. This study aims to identify distinct patterns of eating behaviour, body composition and physical activity between men and women, in order to develop tailored interventions.MethodsA cross-sectional study was conducted on 2,509 adults attending a metabolic health centre. Data on eating habits, physical activity and body composition were collected by means of questionnaires and bioimpedance analysis. PCA was used to identify patterns of eating behaviour and physical activity. Statistical analyses were performed to explore gender-specific differences.ResultsBased on the PCA, five distinct groups of participants were identified: Balanced Eaters, Focused on Home Cooking, Routine Eaters, Restaurant Lovers and Varied Eaters. Significant gender differences in food preferences were observed, with men consuming more meat and women more vegetables. Men also reported greater participation in strength and endurance sports, while women showed a more structured eating routine.ConclusionsThis study, using principal component analysis (PCA), revealed gender-specific patterns in diet, physical activity and body composition. PCA identified five distinct behavioural groups, revealing that men tended to consume more meat and engage in strength training, while women adhered to structured, vegetable-rich diets. The application of PCA provided more insight than traditional analysis, highlighting the complexity of gender-specific behaviour. These results emphasize the need for tailored interventions, focusing on increasing vegetable intake in men and encouraging strength training in women. Future research should exploit PCA to explore behavioural patterns longitudinally for more refined and personalised health strategies.Clinical trials registeredThis study is registered on ClinicalTrials.gov (NCT06654674).

Calorie restriction (CR) and physical exercise (EX) are well-established interventions known to extend health span and lifespan in animal models. However, their impact on human biological aging remains unclear. With recent advances in omics technologies and biological age (BioAge) metrics, it is now possible to assess the impact of these lifestyle interventions without the need for long-term follow-up. This study compared BioAge biomarkers in 41 middle-aged and older adult long-term CR practitioners, 41 age- and sex-matched endurance athletes (EX), and 35 sedentary controls consuming Western diets (WD), through PhenoAge: a composite score derived from nine blood-biomarkers. Additionally, a subset of participants (12 CR, 11 EX, and 12 WD) underwent multi-omic profiling, including DNA methylation and RNAseq of colon mucosa, blood metabolomics, and stool metagenomics. A group of six young WD subjects (yWD) served as a reference for BioAge calculation using Mahalanobis distance across six omic layers. The results demonstrated consistently lower BioAge biomarkers in both CR and EX groups compared to WD controls across all layers. CR participants exhibited lower BioAge in gut microbiome and blood-derived omics, while EX participants had lower BioAge in colon mucosa-derived epigenetic and transcriptomic markers, suggesting potential tissue-specific effects. Multi-omic pathway enrichment analyses suggested both shared and intervention-specific mechanisms, including oxidative stress and basal transcription as common pathways, with ether lipid metabolism uniquely enriched in CR. Despite limitations due to sample size, these findings contribute to the broader understanding of the potential anti-aging effects of CR and EX, offering promising directions for further research.

Intermittent fasting (IF) extends healthspan and lifespan in rodents and has been associated with metabolic benefits in humans, yet results so far have been inconsistent.In this study, we tested the effects of IF-induced weight loss on metabolic and molecular determinants of healthy aging.We performed a randomized clinical trial with a partial cross-over design in overweight men and women (30-65 y, average 49.3 ± 8.2 y) to test the effects of six-month IF (NCT01964118).Fifty participants were randomized to the IF (n = 28) or usual diet (n = 22) group.The primary outcome was the assessment of change in serum C-reactive protein levels from baseline to six months; secondary outcomes were changes in insulin sensitivity using oral glucose tolerance test (OGTT)-based indexes, and plasma metabolomics and gene expression changes in colon mucosa.No difference in serum levels of C-reactive protein or multiple cytokines and chemokines was observed over this period, despite a significant IF-induced 8% weight loss.IF caused a statistically significant but clinically irrelevant small improvement in OGTT-derived insulin sensitivity indexes.Preliminary multi-omic data analysis suggests that a nonlinear relationship exists between IF-induced weight loss and inhibition of multiple key nutrient-sensing aging pathways.More trials are needed to understand the impact of different degrees of energy restriction on metabolic and molecular health in humans, and how fasting should be complemented with diet quality changes during feast days to maximize clinical and longevity outcomes.

Regular endurance exercise training is an effective intervention for the maintenance of metabolic health and the prevention of many age-associated chronic diseases. Several metabolic and inflammatory factors are involved in the health-promoting effects of exercise training, but regulatory mechanisms remain poorly understood. Cellular senescence-a state of irreversible growth arrest-is considered a basic mechanism of aging. Senescent cells accumulate over time and promote a variety of age-related pathologies from neurodegenerative disorders to cancer. Whether long-term intensive exercise training affect the accumulation of age-associated cellular senescence is still unclear. Here, we show that the classical senescence markers p16 and IL-6 were markedly higher in the colon mucosa of middle-aged and older overweight adults than in young sedentary individuals, but this upregulation was significantly blunted in age-matched endurance runners. Interestingly, we observe a linear correlation between the level of p16 and the triglycerides to HDL ratio, a marker of colon adenoma risk and cardiometabolic dysfunction. Our data suggest that chronic high-volume high-intensity endurance exercise can play a role in preventing the accumulation of senescent cells in cancer-prone tissues like colon mucosa with age. Future studies are warranted to elucidate if other tissues are also affected, and what are the molecular and cellular mechanisms that mediate the senopreventative effects of different forms of exercise training.

BACKGROUND:Reducing obesity and weight gain, which often occurs during breast cancer treatment, may represent an efficient secondary or tertiary prevention against cancer.PURPOSE:This retrospective observational cohort study aimed to assess the impact of a Mediterranean diet on weight and anthropometric changes in women completing active breast cancer treatment. Additionally, we sought to identify factors associated with study dropout within one year.METHODS:A total of 182 female patients (20 normal weight, 59 overweight, 103 obese) received personalized Mediterranean diet interventions and underwent monthly outpatient visits.RESULTS:Dropout rates were 42.3% at 6 months and 64.1% at 12 months. Among the obese subgroup, BMI (p < 0.001) and fat mass (p < 0.05) decreased after 6 months. At 12 months, the obese subgroup showed a borderline significant further reduction in BMI (p = 0.062). BMI or weight loss did not predict dropout at any time point. However, age (OR = 0.91) and diastolic blood pressure (OR = 1.07) were significant predictors of dropout at 12 months.CONCLUSION:Implementing a Mediterranean diet can lead to weight and anthropometric improvements in breast cancer survivors. Further research is necessary to explore the long-term effects of weight loss on these individuals, identify effective dietary approaches, and consider specific predictors of dropout.

EDITORIAL article Front. Nutr., 07 July 2023Sec. Clinical Nutrition Volume 10 - 2023 | https://doi.org/10.3389/fnut.2023.1214952